[Objective] To evaluate the clinical outcome of internal fixation with cannulated screws in rhombic configuration and inverted triangular configuration for femoral neck fractures by Meta-analysis. [Methods] The CNKI, VIP, Wanfang Medical Database, Sinomed, Pubmed, Embase, Web of Science, and The Cochrane Library were searched up to March 2022, for studies concerning the comparative efficacy of applying cannulated screws with rhombic and inverted triangle-configuration for femoral neck fracture fixation. Two researchers independently screened literature according to the inclusion and exclusion criteria, extracted data and assessed the methodological quality of included studies. The meta-analysis were performed by using RevMan 5.3 software. [Results] Six cohort studies with 435 patients were finally included, including 207 in the rhombic group and 228 in the inverted triangle group. Meta-analysis showed that in both groups: blood loss during operation [MD=3.69，95%CI(1.31，6.06)，P = 0.002] and Harris score at the last follow-up [MD=4.82，95%CI(4.40，5.24)，P=0.004] were statistically significant, and the differences in operative time, nail retreat rate, nonunion rate , femoral head necrosis and femoral neck shortening rate between the two groups were not statistically significant. [Conclusion] The Harris score of rhombic group is better than that of inverted triangle group, and the bleeding volume of inverted triangle group is lower than that of rhombic group. There may be no significant difference between the two groups in terms of long-term complications such as fracture nonunion rate, femoral head ischemic necrosis rate, nail withdrawal rate, femoral neck shortening and so on.